The following demographic information is optional.

Question Title

* The following demographic information is optional.

This information will be used to better serve you and your family.

2. What is the age range of your son(s)? Please check all that apply

Question Title

* This information will be used to better serve you and your family.

2. What is the age range of your son(s)? Please check all that apply

3. Below are 5 concerns that have been expressed by single mothers raising boys across the country, and we would like to know what concerns you most.

On a scale of 1 to 5 please rate the following concerns.
1 being the least concern and 5 being the greatest concern.

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* 3. Below are 5 concerns that have been expressed by single mothers raising boys across the country, and we would like to know what concerns you most.

On a scale of 1 to 5 please rate the following concerns.
1 being the least concern and 5 being the greatest concern.

  Extremely Important Very Important Mildly Important Somewhat Important Not Important N/A
Academic Achievement
Father Involvement
Finding Male Mentors
Peer Pressure
School Environment
Finances
Day Care/Child Care
Other (please specify)
4. Please specify if you stated other in the previous question:

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* 4. Please specify if you stated other in the previous question:

5. Do you feel that your son has a positive male role model? (Ex. Other family members, teachers, mentors etc.)

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* 5. Do you feel that your son has a positive male role model? (Ex. Other family members, teachers, mentors etc.)

6. Are there free or affordable after school activities and resources available for your son in your community? (Recreation Center, Sports Team, clubs, etc.)

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* 6. Are there free or affordable after school activities and resources available for your son in your community? (Recreation Center, Sports Team, clubs, etc.)

7. Do you have free/personal time to do something for yourself (Ex. relaxing, exercise, hobby). If not, how does this effect your daily life?

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* 7. Do you have free/personal time to do something for yourself (Ex. relaxing, exercise, hobby). If not, how does this effect your daily life?

8. Do you have any concerns about your housing or neighborhood? (Crime, Gang Activity, etc.)

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* 8. Do you have any concerns about your housing or neighborhood? (Crime, Gang Activity, etc.)

9. During these troubling economic times are you and your son's basic needs being met? Such as (food, clothes, etc.)

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* 9. During these troubling economic times are you and your son's basic needs being met? Such as (food, clothes, etc.)

10. How would you rate your son and his father's relationship?

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* 10. How would you rate your son and his father's relationship?

  N/A
Exceptional
Great
Okay
Non-existant

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